Help
Subscribe


GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy

 27 June 2017

Advanced search
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy Profile of Roy Pounder

Home

News  
Journals
Review Articles
Slide Atlas
Video Clips
Online Books
Advanced Digestive Endoscopy
Classical Cases
Conference Diary
PubMed
International GH Links
USA GH Links
National GH Links
National GI Societies
Other Useful Links




Emails on Gastroenterology and Hepatology
the National AIDS Treatment Advocacy Project
Visit the gastroenterology section of the EUMS

News

Enhancing the diagnosis of gastro-esophageal reflux disease

Diagnosis of gastro-esophageal reflux disease is enhanced by adding esophageal histology and excluding epigastric pain, reports the latest issue of the Alimentary Pharmacology & Therapeutics.

News image

The diagnosis of gastro-esophageal reflux disease (GERD) in clinical practice is limited by the sensitivity and specificity of symptoms and diagnostic testing.

Professor Vakil and colleagues from Wisconsin, USA determined if adding histology as a criterion and excluding patients with epigastric pain enhances the diagnosis for GERD.

Patients with frequent upper gastrointestinal symptoms who had not taken a proton pump inhibitor in the previous 2 months, and who had evaluable distal esophageal biopsies were included. 

Epithelial hyperplasia was identified when total epithelial thickness was at least 430 μm. 

The team's investigation-based GERD criteria included presence of erosive esophagitis, pathological esophageal acid exposure, and/or positive symptom–acid association probability. 

Adding epithelial hyperplasia as a criterion increased the diagnosis of GERD to 67%
Alimentary Pharmacology & Therapeutics
The researchers assessed symptoms using the Reflux Disease Questionnaire, and a pre-specified checklist.

Overall, the team found that 55% of the 231 included patients met investigation-based GERD criteria, and 84% met symptom-based criteria. 

Epithelial hyperplasia was present in 89 individuals, of whom 69% met investigation-based criteria, and 93% met symptom-based criteria. 

The researchers noted that adding epithelial hyperplasia as a criterion increased the number of patients diagnosed with GERD on investigation to 67%. 

The proportion of patients with a symptom-based GERD diagnosis who met investigation-based criteria including epithelial hyperplasia was significantly greater when concomitant epigastric pain was absent than when it was present.

Professor Vakil's team comments, "Histology increases diagnosis of GERD, and should be performed when clinical suspicion is high and endoscopy is negative."

"Excluding patients with epigastric pain enhances sensitivity for the diagnosis of GERD."

Aliment Pharmacol Ther 2017: 45(10): 1350–1357
20 April 2017

Go to top of page Email this page Email this page to a colleague

 27 June 2017 
Health-related quality of life in eosinophilic esophagitis
 27 June 2017 
Extraintestinal manifestations of IBD
 27 June 2017 
Viral cancers in Barrett’s
 26 June 2017 
Anger in HIV-HCV co-infected patients
 26 June 2017 
Iron and IBD risk
 26 June 2017 
Weight loss for low-income postpartum women
 23 June 2017 
Treatment for KRAS wild-type advanced colorectal cancer
 23 June 2017 
Epidemiology of Hep E
 23 June 2017 
Predictive model for clinical course of Crohn's disease
 22 June 2017 
Vonoprazan-based triple therapy on H. pylori eradication
 22 June 2017 
Adolescent transition in IBD
 22 June 2017 
Patient understanding of biologic therapy in IBD
 21 June 2017 
Statins in chronic Hep C
 21 June 2017 
Racial disparities in colorectal cancer
 21 June 2017 
Hydrolyzed wheat flour improves immunogenicity in celiac disease
 20 June 2017 
Therapies in chronic pancreatitis
 20 June 2017 
Genetic analyses for malignancy detection in biliary strictures
 20 June 2017 
Viral-associated esophagus cancers
 19 June 2017 
Global prevalence of IBS in adults
 19 June 2017 
Clinical improvement in mild acute pancreatitis
 19 June 2017 
Repeat biopsy and celiac disease outcomes 
 16 June 2017 
Exercise-induced GI syndrome—implications for intestinal disease
 16 June 2017 
HCV among reproductive-aged women and children in the USA
 16 June 2017 
Adverse events after outpatient colonoscopy
 15 June 2017 
Pioglitazone for NASH
 15 June 2017 
Treatment of eosinophilic esophagitis
 15 June 2017 
Urinary adverse events after rectal cancer treatment
 14 June 2017 
Genetics of familial colorectal cancer
 14 June 2017 
Abdominal ultrasound in blunt torso trauma
 14 June 2017 
Acute kidney injury in Hep C and sofosbuvir-based regimens
 13 June 2017 
Serrated polyps in the colon and rectum
 13 June 2017 
Colorectal cancer during pregnancy
 13 June 2017 
Biomarker for penetrating Crohn's
 12 June 2017 
Course of primary sclerosing cholangitis
 12 June 2017 
Quality of life in end-stage liver disease
 12 June 2017 
Clinical remission in patients with Crohn's disease
 09 June 2017 
Socioeconomic influences on H. pylori gastritis
 09 June 2017 
Celiac disease in Ireland
 09 June 2017 
Consultants do not follow up on GI tests they recommend
 08 June 2017 
Genetics and the gut microbiota and metabolic syndrome
 08 June 2017 
Antireflux surgery in extraesophageal reflux
 08 June 2017 
Breath testing in gastrointestinal disorders
 07 June 2017 
Multidisciplinary care and liver cancer
 07 June 2017 
Model for excluding NAFLD
 07 June 2017 
Hospital readmission in IBD
 06 June 2017 
Dietary patterns and colorectal cancer risk
 06 June 2017 
Direct-acting antiviral agents for HCV
 06 June 2017 
Medical therapies for stricturing Crohn’s
 05 June 2017 
Hospital-acquired conditions in Crohn’s disease
 05 June 2017 
Celiac disease prevalence in the USA
 05 June 2017 
Depression and IBD
 02 June 2017 
Menopausal hormone therapy and fecal incontinence
 02 June 2017 
Narcotic and corticosteroid prescriptions in IBD
 02 June 2017 
Treating anemia after gastrectomy
 01 June 2017 
Infliximab and cancer in pediatric IBD
 01 June 2017 
Health insurance policies in IBD
 01 June 2017 
Endoscopic quality improvement program for polyp detection
 31 May 2017 
Probiotics and Clostridium difficile infection
 31 May 2017 
Post-procedural adverse events after colonoscopy
 31 May 2017 
Clinical decision-making in severe alcoholic hepatitis

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2017 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us